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发展中国家神经外科患者管理的低成本质量举措:来自巴基斯坦一家三级护理中心的视角

Low cost quality initiatives for management of neurosurgical patients in developing nations: Perspective from a tertiary care centre in Pakistan.

作者信息

Rai Hamid H, Waqas Muhammad, Shamim Muhammad S

机构信息

Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Surg Neurol Int. 2017 Mar 14;8:35. doi: 10.4103/sni.sni_352_16. eCollection 2017.

Abstract

BACKGROUND

Targeting resources on cost-effective care strategies is pertinent for developing nations, specifically for already burdened specialties such as neurosurgery, where without state support and insurance companies, expenses are borne by the patient themselves.

METHODS

This was a descriptive review of literary work published by the section of neurosurgery at Aga Khan University Hospital, Pakistan. We searched PubMed and CiNAHL databases to identify articles, which were then critically analyzed and discussed from a perspective of low-cost quality care.

RESULTS

We demonstrate the cost effectiveness of three initiatives, namely, blood ordering protocol for elective spine arthrodesis, nonoperative management being superior to surgical stabilization in spine injury patients with complete neurological deficits, and early tracheostomy in patients with isolated severe traumatic brain injury.

CONCLUSION

Initiation and implementation of such cost-effective strategies without compromising quality health standards must be emphasized by neurosurgical centers throughout the developing world for smart allocation and utilization of funds.

摘要

背景

将资源集中于具有成本效益的护理策略对发展中国家至关重要,特别是对于像神经外科这样已经负担沉重的专科,在没有国家支持和保险公司的情况下,费用由患者自行承担。

方法

这是对巴基斯坦阿迦汗大学医院神经外科发表的文献作品的描述性综述。我们检索了PubMed和CINAHL数据库以识别文章,然后从低成本优质护理的角度对其进行批判性分析和讨论。

结果

我们展示了三项举措的成本效益,即择期脊柱融合术的用血订购方案、在完全神经功能缺损的脊柱损伤患者中,非手术治疗优于手术固定,以及在孤立性严重创伤性脑损伤患者中早期气管切开术。

结论

发展中国家的神经外科中心必须强调在不影响优质健康标准的情况下启动和实施此类具有成本效益的策略,以便明智地分配和利用资金。

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